Wayne Anton Misselbeck, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

42-0007390 Issued in VT

Practice address

36 S Main St
Gifford Medical Center Emergency Department
Randolph, VT 05060-1370

Phone

(802) 728-7000

NPI assigned

Jul 10, 2006

Last updated

Feb 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Vermont Medical Center Inc

  dba Uvm Medical Center

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615

  Emergency Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1326072281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 ATKINS BAY LN",
            "city": "NORTH HERO",
            "state": "VT",
            "postal_code": "054749757",
            "telephone_number": "802-372-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S MAIN ST",
            "address_2": "GIFFORD MEDICAL CENTER EMERGENCY DEPARTMENT",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601370",
            "telephone_number": "802-728-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSELBECK",
        "first_name": "WAYNE",
        "middle_name": "ANTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "42-0007390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009231",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E01066279",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80009231",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brigid Joanna Meehan-Brese
• Amber Menard, BS
• Lucy Merriam, MD
• August R. Meyer, PH.D.
• Lee Milian, MA
• Amanda Monti, AS
• Robert M Naylor, M.D.
• Maureen Dacey Nevers, CCC-SLP
• Chris H Nevin, LCMHC
• Kelsey Norton, HSD

• Emergency Medicine Physician in Randolph, VT
• Providers in Randolph, VT by specialty
• Emergency Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.